Registration Form

Liberty Hill School of Music & Dance

You lesson has been confirmed via email. Please fill out the following information.
Student Name (first and last)*
First Name
Birth Date*

MonthDayYear
Age (as of today's date)*
Adult students may type "adult"
Parent/Guardian Name (First, Last)*
Primary Phone Number*
Parent/Guardian E-mail*
This email will be used for a member of our team to contact you with final registration steps.
What instrument are you wanting to sign up for?*

PianoVoiceGuitarPercussionOther
Do you have your own instrument at home? Please understand it is absolutely necessary for students to have their own instrument prior to their first lesson.*

YesNo, I would like information on how/where to purchase?
Preferred instructor:*

I have no preference and would love your recommendation.Dan Moyer (percussion)Dave Dunkin (guitar, bass, ukulele, voice)Tommy Williams (acoustic/electric guitar)Liam Wallace (percussion)Maggie Greenless (piano)Kim Feinauer (piano, brass)Stephanie Andrew (piano, voice)Tammy Ramalho (piano, voice, clarinet)
Day of the week that works best for you (instructor availability is not guaranteed by for each day):*

I am flexibleMondayTuesdayWednesdayThursdayFridaySaturday
What time of day works best for you? (Note: instructor availability is not guaranteed by for each day):*

Mornings this option is typically reserved for Saturdays and during the week for homeschool families and is not a summer option for students returning to school)Afternoons (3:00-5:30)Evenings (6:00-8:00)
How did you hear about us?*

Social Media (Facebook, Instagram, etc.)Google SearchWebsiteFriend/Family ReferralLocal Event or FestivalOther
Any additional information you would like us to know (previous experience, special accommodations, etc):
Payment Policy Acknowledgements
Tuition: Tuition is invoiced on the 1st of the month and due by the 5th of the month. If payment has not been received by 11:59pm on the 5th of each month, a $15.00 late fee will be assessed as of the 6th of the month. If your FIRST first lesson falls in the middle of the month, you/your child's tuition will be prorated for the first month to reflect only the lessons you actually receive. After that, a monthly flat rate will be charged and tuition remains the same each month.*

I agree
Occasionally, students will receive fewer lessons in a month due to the presence of a major holiday. However, all students receive extra lessons throughout the year because some months have more than 4 weeks. Months with 5 lessons balance out the occasional months where a holiday causes a student to receive fewer lessons. When comparing tuition between studios, remember that some studios increase tuition or skip lessons for months that have an extra (5th) lesson. At Liberty Hill School of Music, the 5th lesson is always included at no extra charge.*

I agree
Transactions declined because of insufficient funds, past expiration dates or closed accounts, incur a $15 fee in addition to the month’s tuition charges. To avoid unnecessary fees, please remember to let us know if you close your account, change banks or want to use a different account/credit card, or need to update the information on an existing credit card.*

I agree
Studio Closures Policy Acknowledgment
For the 24-25 school year, Liberty Hill School of Music will follow the Liberty Hill ISD calendar for major holidays only. We will be closed for Thanksgiving break, Christmas/Winter break, and Spring break, July 3rd, 4th & 5th. There are no tuition adjustments or make-up lessons given for lessons that fall on the above major holidays because all students receive additional lessons throughout the year at no extra cost on months where an extra (5th) week occurs. If Liberty Hill ISD is closed for a staff in-service/professional development day, we are OPEN. When in doubt please call/text/email the owner/office manager so you do not forfeit you/your child's lesson.*

I agree
Make-Up Lesson Policy Acknowledgements
Liberty Hill School of Music does not offer makeup lessons for student cancellations due to instructor availability and studio space availability. Make-up lessons are only offered to students in the event an instructor has to cancel class.*

I agree
In the case of inclement/extreme weather conditions, or circumstances beyond our control, we reserve the right to close the studio out of safety for our students & staff. In such cases, we will not offer a make up lesson due to lack of additional time/space for such make up lessons.*

I agree
Withdrawl from Lessons Policy Acknowledgment
In the case of a student withdrawing or discontinuing lessons indefinitely, parents/guardian, not minor students, must contact the studio owner/office manager, NOT YOUR INSTRUCTOR, no later than the 15th day of the month for withdrawl from lessons and cessation of tuition charges. Withdrawl notice submitted after the 15th of the month will result in tuition being charged for the following month even if you choose not to or are unable to attend those lessons. You may either email lhmusic512@gmail.com or call/text us at 512-350-5607. To avoid potential miscommunications, we do not accept communications with your instructor, they do not handle billing. Please contact the owner/office manager.*

I agree
Leave of Absence Policy Acknowledgment
In the case of a student discontinuing lessons temporarily, parents/guardians, not minor students, must contact the studio owner/office manager, NOT YOUR INSTRUCTOR, no later than the 15th day of the month for withdrawl from lessons and cessation of tuition charges. If you must miss lessons for an extended period of time (more than 2 weeks), please let us know with as much advance notice as possible. It is sometimes possible for a student to return to lessons in their old time slot, but we CANNOT “hold” or guarantee the student’s old time slot when the student will miss lessons for an extended period of time and does NOT wish to be charged during the time when lessons are being missed. In order to hold your spot, full tuition is required. You may either email lhmusic512@gmail.com or call/text us at 512-350-5607. To avoid potential miscommunications, we do not accept communications with your instructor, they do not handle billing. Please contact the owner/office manager.*

I agree
WAIVER/INDEMNITY OF LIABILITY:

I agree to assume the risk of any injury that may happen to me (or my child) as a result of participation in classes at Liberty Hill School of Music. I further agree to indemnify and hold the Liberty Hill School of Music and their agents, or instructors harmless from any loss sustained as a result of injury to me (or my child) as a result of participation in Liberty Hill School of Music classes or events. By participating in Liberty Hill School of Music classes and events, I give Liberty Hill School of Music permission to use photos and video of myself (or my children) taken in conjunction with Liberty Hill School of Music classes or events.
Waiver/Indemnity Agreement*

I agree
Signature*

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Liberty Hill School of Music & Dance

Payment Policy Acknowledgements

Studio Closures Policy Acknowledgment

Make-Up Lesson Policy Acknowledgements

Withdrawl from Lessons Policy Acknowledgment

Leave of Absence Policy Acknowledgment

WAIVER/INDEMNITY OF LIABILITY: